OLIVER MATTHEWS: Getting sick in Zimbabwe shouldn’t mean disaster. But it does


At the airport in Harare last week, I met an elderly couple. Clearly unwell, the husband was flying out of Zimbabwe.

"He's sick. Cancer," his wife said. He'd fallen ill with a hernia not long back. But when the doctors had operated on him - at a cost of US$2,000 in a country where technically you're not supposed to ask for US dollars - they'd found something more serious.

To operate on that in a far-from-elite clinic near Harare? US$10,000. The kind of sum struggling medical insurances in Zimbabwe just won't cover. So, this couple was hoping that he could get medical help in the UK.

"I've applied for a visa to follow him, but I don't know if I'll get it," the wife said.

Falling seriously ill is hard wherever you live.

But in Zimbabwe, where the local currency is devaluing and yet hardly anyone has access to the US dollar, it can be doubly dangerous.

On Friday rates for the greenback - even at legally-operating bureaux de change - hit 20:1.

An average salary is 500 Zimbabwe dollars. Two years ago, that meant US$500. Today it means the equivalent of US$25.

Teachers, doctors, managers: many earn little more than this a month. That's not enough to feed a family, let alone seek medical help.

And if you do manage to scrape together the cash for a consultation at a private hospital, this month doctors and nurses have been on strike.

They went on strike on 3 September. Peter Magombeyi, a prominent doctor who disappeared last weekend, had supported that strike. He was found - reportedly unharmed - late on Thursday. In the intervening days, doctors and nurses withdrew what services remained in protest.

The government of Emmerson Mnangagwa drafted in army doctors last week to help, as it has done in similar strikes over the years.

For the few still trying to keep public hospitals running, scenes inside have been stressful.

One doctor told me on condition of anonymity that Harare Central - the hospital where Magombeyi normally works - couldn’t cope with its load of casualty patients on Monday night.

Just one nurse was on duty to deal with patients in the hospital’s resuscitation area.

“She couldn’t move them out as there were no other nurses available. There were no porters to take the patients to the ward, and even if they got to the ward, there was nobody there.”

This was the doctors' third strike this year. It's not just about pay. The doctors say they can’t do their jobs properly or safely: hospitals aren’t adequately equipped. They don’t even have surgical gloves. As the doctors said in their petition they delivered to parliament on Thursday, hospitals are now “a health hazard”, both for medical staff and patients.

Mnangagwa's government has introduced unpopular austerity measures - with some monitoring from the International Monetary Fund - to kick-start the economy after more than three decades of downturn. Few ordinary Zimbabweans seem to have been able to foresee just what that would mean for the man in the street.

Life and death healthcare is one side-effect.

If you have money - access to a salary that's pegged to the US, for example - there are ways round the healthcare crisis.

Private clinics around the country were still admitting patients for operations this week.

I know of an elderly patient in the east of the country who was admitted for a hernia operation at a private facility in her town on the very day doctors in Harare were marching after a High Court order gave them the go-ahead. If there were patients in public hospitals that day, few were thinking of them.

Zimbabwe’s is a tale of two health systems. One for the wealthy, the other for the rest.

The thing is, the health system that most people depend on is very nearly non-functioning. And that has to be a disaster.

Oliver Matthews is a freelance reporter based in Zimbabwe.